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Re:Cognitive deficits in people who have recovered from Covi... by redis_mlc on Wednesday October 21, 2020 @06:52AM (#24846532)
> the hospitalised with ventilator sub-group

So this affects almost nobody then, and is probably caused by the sedatives, immobilization and ventilator organ damage, aside from corona.

Re:Cognitive deficits in people who have recovered from Covi... by ghufran_syed on Wednesday October 21, 2020 @07:12AM (#24846623)
Not sure why you’re getting downvoted - here’s a page about post-intensive care syndrome, on the website of the society for critical care medicine, that’s concordant with what you said: https://www.sccm.org/MyICUCare/THRIVE/Post-intensive-Care-Sy...
Re:Cognitive deficits in people who have recovered from Covi... by rfrey on Wednesday October 21, 2020 @08:57AM (#24847357)
Possibly for what HN calls "middlebrow dismissal" - wandering in and dismissing the article with blindingly obvious issues ("probably caused by the sedatives, immobilization" etc) as if professional medical researchers wouldn't have thought of them. They plainly need a clear-eyed HN reader on staff to help them.
Re:Cognitive deficits in people who have recovered from Covi... by ardy42 on Wednesday October 21, 2020 @09:12AM (#24847502)
> Possibly for what HN calls "middlebrow dismissal" - wandering in and dismissing the article with blindingly obvious issues ("probably caused by the sedatives, immobilization" etc) as if professional medical researchers wouldn't have thought of them. They plainly need a clear-eyed HN reader on staff to help them.

That term is very apt. I found this blog post about it, which I think really hits the nail on the head, too:

http://www.byrnehobart.com/blog/why-are-middlebrow-dismissal...

> Paul Graham, News.YC’s moderator emeritus, says that “The defining quality of the middlebrow dismissal is that it’s a cache dump of the writer’s prejudices…” This probably explains why they’re so common. It’s natural to see any news story as confirmation of your existing prejudices—but it’s easy to read confirmation where it’s not there. So it’s easy to see Groupon or Zynga as a “failure” for being worth merely a couple billion dollars when they were once worth ten billion plus apiece. (You could get pretty rich failing like that a few times.)

> But the real driver is not just that it’s easy to misread a story as confirming your beliefs. It’s that the alternative is to read a story and realize you were wrong. And since a middlebrow dismissal is a dismissal of something, it’s generally a dismissal of something that disagrees with the reader’s bias.

Re:Cognitive deficits in people who have recovered from Covi... by milesvp on Wednesday October 21, 2020 @11:47AM (#24848970)
That last paragraph was oddly hard for me to parse this morning, possibly because I havn’t thought enough about this aspect of confirmation bias.

Be conciencious when dismissing something that’s inconsistent with your world view, seems like very good advice, at least if the source is credible.

Re:Cognitive deficits in people who have recovered from Covi... by ghufran_syed on Wednesday October 21, 2020 @09:54AM (#24847893)
Ahh, that's helpful, thanks! I think I unconsciously strip out a lot of that tone when I read, but I can see how it would be unhelpful
Re:Cognitive deficits in people who have recovered from Covi... by irq11 on Wednesday October 21, 2020 @10:39AM (#24848305)
A bigger problem on HN these days is the highbrow lowbrow dismissal, wherein people come up with fancy-sounding reasons for rejecting comments, that are actually themselves lazy/incorrect arguments.

For example: when the paper itself says that the cognitive declines seen in people who don’t spend time hospitalized are a small fraction of the magnitude of the cognitive declines seen in hospitalized patients (Figures 2, 3; in some cases a cognitive benefit is seen in mild cases), yet a comment observing that the effects are confined to a small population is dismissed for the reason that “professional medical researchers would have thought of that”.

Re:Cognitive deficits in people who have recovered from Covi... by rfrey on Wednesday October 21, 2020 @10:59AM (#24848499)
I was specifically referring to the claim the effects were probably due to sedation, etc. , not the observation that the study was of hospitalized cases.
Re:Cognitive deficits in people who have recovered from Covi... by irq11 on Wednesday October 21, 2020 @11:14AM (#24848614)
So? The OP observed that the most severe effects were in a very small population of hospitalized patients. You fixated on a (plausible) hypothesis made that this could be due to sedation, and used it to reject the entire argument, even though the OP’s point is right, and your argument is a lowbrow dismissal that “experts would have thought of it”.

By the way: as far as I can tell, the paper doesn’t discuss this issue anywhere.

[dead]
Re:Cognitive deficits in people who have recovered from Covi... by irq11 on Wednesday October 21, 2020 @04:32PM (#24851841)
So, your only response is to make an insult based on my comment history.

What a compelling, “high brow” response.

Re:Cognitive deficits in people who have recovered from Covi... by bildung on Wednesday October 21, 2020 @07:53AM (#24846892)
Probably because according to the paper, Covid-positive patients not on ventilators also had the mental impairment problems, only to a lesser degree.
Re:Cognitive deficits in people who have recovered from Covi... by darkerside on Wednesday October 21, 2020 @08:33AM (#24847132)
He's replying to the comment in front of him. Seems relevant.
Re:Cognitive deficits in people who have recovered from Covi... by bregma on Wednesday October 21, 2020 @08:36AM (#24847147)
I think it was the 'almost nobody' crack. Everybody is somebody.
Re:Cognitive deficits in people who have recovered from Covi... by noja on Wednesday October 21, 2020 @07:16AM (#24846645)
> Not sure why you’re getting downvoted

I think he overlooked that the people were hospitalized and on ventilators because they had covid.

Re:Cognitive deficits in people who have recovered from Covi... by xd on Wednesday October 21, 2020 @07:21AM (#24846674)
But it's still an effect of the treatment. If you perform a study on people whom have been ill you're going to get results that show all the symptoms of illness.. the study could have been done with any illness and likely show cognitive decline.
Re:Cognitive deficits in people who have recovered from Covi... by shultays on Wednesday October 21, 2020 @07:39AM (#24846785)
symptoms of illness is the illness itself. Ignoring these symptoms of covid or results of the treatment is saying something like "bullets don't kill people, it ruptures blood vessels and you die due to loss of blood"
Re:Cognitive deficits in people who have recovered from Covi... by srtjstjsj on Wednesday October 21, 2020 @08:23AM (#24847052)
You misunderstand the ambiguous wording. If you study only includes people with an illness, the illness itself is a confounder.

The point is that if you have a non-ICU covid case, this research is unlikely to apply.

Re:Cognitive deficits in people who have recovered from Covi... by jrumbut on Wednesday October 21, 2020 @10:37AM (#24848284)
It feels like we didn't read the same article, they break down numbers for people on ventilators but also hospitalized, non-ventilator patients all the way down to those who received no particular care.

The findings were concerning to anyone who had it, they also mention cases where the cognitive deficit was the first reported symptom.

Re:Cognitive deficits in people who have recovered from Covi... by _pmf_ on Wednesday October 21, 2020 @08:33AM (#24847130)
Symptoms from chemo therapy are NOT commonly classified as symptoms of the cancer that it's supposed to treat.

Why do we have to make up extra rules for everything Covid-19 related?

Re:Cognitive deficits in people who have recovered from Covi... by nate_meurer on Wednesday October 21, 2020 @02:06PM (#24850438)
This is a good analogy, but the conclusion I take from it is different from yours. Whether an effect of a disease is a symptom of the treatment or of the disease itself doesn't matter to me. Either way, I'd rather not get the disease if I can help it.
Re:Cognitive deficits in people who have recovered from Covi... by luckylion on Wednesday October 21, 2020 @08:23AM (#24847057)
> symptoms of illness is the illness itself

Is it a symptom of the illness or a symptom of the treatment? If you had a better treatment protocol, would it still happen to the same degree?

Re:Cognitive deficits in people who have recovered from Covi... by fogihujy on Wednesday October 21, 2020 @07:08AM (#24846607)
Well, the fact that someone was uable to breathe on their own also suggests that the virus may have caused a lack of oxygen to the brain. In such circumstances brain damage is quite likely, and then the disease would indeed be the cause.

Fortunately, the group of people that end up on ventilators is not really that large, and I can imagine minor brain damage would still be preferable to death in many of those cases.

As a sibling commented, theeffects that won't start to manifest until a year or two has passed are more worrying. There's simply so much we don't know about this virus yet.

Re:Cognitive deficits in people who have recovered from Covi... by neuronic on Wednesday October 21, 2020 @07:38AM (#24846781)
People are unable to worry about or comprehend the effects that happen right NOW. I am a staunch believer in post-viral syndrome as I experienced it first hand following an Epstein-Barr infection (mono) but aside from a handful of researchers nobody cares at all. For most physicians, it isn't even within the realm of possibilities when you come to them with random maladies. Boom, now you have anxiety because that's what they tell you when they don't know shit.

There are so many bodily issues that arose after my Epstein-Barr infection, it's not funny at all. I can absolutely lead a normal life and am active and athletic.

But things like autoimmune issues, persistent 15-year brain fog (I'd rather call it frosted glass layer) which randomly clears once a month to remind me how nice it is to be able to think straight, or full-body-numbing attacks in the middle of a gas station. The first 5 years after the disease I regularly felt like passing out. Later I just got dizzy and learned to control it using water and temperature changes (cold water in back of your neck!).

I still took on the anxiety story and did something against it. It helped me in many ways but not with post-viral syndrome. It's real and it sucks but it's not being taken seriously at all.

I am afraid, some COVID survivors are in for a new life which is different in just the right (but minor) ways to drive you insane. Body just doesn't feel the same as before.

Re:Cognitive deficits in people who have recovered from Covi... by diu7sieQuee9jai on Wednesday October 21, 2020 @08:24AM (#24847063)
I have been dealing with something that sounds very much like what you describe. It started a few years ago. At the moment it is manageable. I've been in and out of many many doctors' offices. Bloodworks actually indicated a recent (but past) EBV infection, that's why your post rang bells with me.

Would you have pointers to how to nail this down? Introductory material or such?

I have to say I really feel your description of the anxiety cop-out. I literally had doctors shouting at me "you are not sick what are you doing here" at some point when I was sitting there already nearly crying because once more I was sitting there, mostly fine, when a few hours ago I was barely able to get up, let alone get on a bike to go to a doctor. And yes, "anxiety disorder" was diagnosed, but no treatment... because I guess the solution is just to "man up" right and stop being such a wussy. :(

Edit:

since others are sharing their experience of the cognitive impact, I'm gonna chime in here.

For me, the episodes came in two flavors:

1. I was feeling weak, and felt like falling. That was both in reality (I was having trouble staying upright and had to lean and hold onto everything and anything while standing/walking) and in my head. It wasn't so much that the world was spinning. It was more like sitting on a chair, rocking back and forth on the hind legs only. And then the moment when you realize you lost your balance and are going to fall over backward. That feeling.

2. I was also feeling weird but had no trouble with balance. However, the whole world suddenly seemed unreal and far away. Like seen through a bad CCTV screen.

Needless to say, both of those states, experienced at random times over months and months, with no explanation, and little support from doctors who were either uninterested or seemed to think I was just seeking attention, did indeed make me more anxious than I ever was.

Re:Cognitive deficits in people who have recovered from Covi... by darkerside on Wednesday October 21, 2020 @08:46AM (#24847265)
Sounds similar to Lyme disease as well. I think the body deals with some persistent infections in a similar way, but I've also observed that there is little interest in researching or treating these conditions.
Re:Cognitive deficits in people who have recovered from Covi... by treeman79 on Wednesday October 21, 2020 @08:57AM (#24847362)
Autoimmune patients often get checked for Lyme, as the symptoms line up well.

Sjogrens, a cousin of lupus, has an insane amount of odd issues associated with it. POTS symptoms, lots of various organ involvement, brain fog, etc.

Re:Cognitive deficits in people who have recovered from Covi... by diu7sieQuee9jai on Wednesday October 21, 2020 @08:57AM (#24847363)
Well maybe now we'll get some more interest in it... Hooray! /s
Re:Cognitive deficits in people who have recovered from Covi... by bamboozled on Wednesday October 21, 2020 @11:41AM (#24848903)
I was diagnosed with depersonalization when I was a teenager suffering from severe anxiety and depression. Sounds. Exactly the same.

Especially the bit about doctors telling you that you’re ok but that you don't want to accept it. This sounds like hypochondria?

Re:Cognitive deficits in people who have recovered from Covi... by diu7sieQuee9jai on Wednesday October 21, 2020 @12:48PM (#24849577)
> sounds like hypochondria?

I can assure you that I have considered that. Still do. But ultimately, that would mean "learning" to not believe my own physical reality. I'm very much into intersubjectivity, but this is the one exception. That would be different if any of those doctors had actually seen me during an episode. The only time that happened however was when I was visiting friends. I had an episode while just hanging out there (holiday season stuff) and there happened to be a physician in the house when it hit. That guy never asked whether what I'm feeling was real. So it's that guy and me, vs a bunch of people who have never seen it happen.

Re:Cognitive deficits in people who have recovered from Covi... by bamboozled on Wednesday October 21, 2020 @12:50PM (#24849615)
I hope you find the help you need whatever that may be. It sounds like a really difficult thing you're going through.
Re:Cognitive deficits in people who have recovered from Covi... by fogihujy on Wednesday October 21, 2020 @09:03AM (#24847407)
I'm sorry to hear that, but I'm glad you managed to learn to control it somehow.

I personally know two COVID survivors who are experiencing a barrage of various symptoms several months after they were told they were healthy, and new symptoms keep appearing. Both have been in contact with other survivors who've reported the same thing.

Now obviously this is just a single data point (or two depending on how you see it), and I am no medical professional, but I have no doubt what they're experiencing is real and a direct result of COVID. If we assume there are others, even if it is just a small percentage of the people who recover, then we're still going to end up with a shitload of people who will live with a multitude of issues that will make life very difficult. And the worst case is we don't know how much more is to come.

Re:Cognitive deficits in people who have recovered from Covi... by rtp on Wednesday October 21, 2020 @07:42AM (#24846819)
It's amazing how people think a virus that lives latently in B cells and epithelial cells, and is strongly associated with various forms of cancer among a big helping of autoimmune disorders, is incapable of causing post-viral syndromes. No, it must be anxiety, of course!

EDIT: Just because a disease makes you frustrated because you can't really do anything about it except empathize and listen, doesn't mean you can just slap the anxiety band-aid on it and call it a day.

Re:Cognitive deficits in people who have recovered from Covi... by neuronic on Thursday October 22, 2020 @04:41AM (#24855994)
Correct, I don't expect doctors to cure me. I expect them to acknowledge that EBV could play a part here. But nope, just anxiety.
Re:Cognitive deficits in people who have recovered from Covi... by nradov on Wednesday October 21, 2020 @08:44AM (#24847239)
Post viral fatigue syndrome has been observed following infection with many different viruses which "include Coxsackie B viruses, EBV, CMV, influenza, various arboviruses, HHV-6, and HTLV -1 and 2".

https://www.sciencedirect.com/topics/medicine-and-dentistry/...

Re:Cognitive deficits in people who have recovered from Covi... by biolurker1 on Wednesday October 21, 2020 @03:55PM (#24851401)
With this kind of argument if HIV2 comes we shouldn't worry because these symptoms already exist with HIV1
Re:Cognitive deficits in people who have recovered from Covi... by throwaway1092 on Wednesday October 21, 2020 @08:02AM (#24846935)
> But things like autoimmune issues, persistent 15-year brain fog (I'd rather call it frosted glass layer) which randomly clears once a month to remind me how nice it is to be able to think straight

I've been experiencing something similar for the past 5 years: brain fog (frosted glass is a much better way of putting it.) and some short term memory issues. The doctors put me through a battery of tests to find...that they could find no reason for my ailment. Curious to know what if anything has helped you the most. The 'randomly clearing' brain fog for a day happens to me maybe once every 3 months and it's both a blessing and a curse.

Re:Cognitive deficits in people who have recovered from Covi... by jokab on Wednesday October 21, 2020 @08:40AM (#24847199)
Sorry to hear this. I cured mine with a CPAP machine. I had to be tested with apnea twice bc the first one came out ok but i wasnt convinced.

In any case, i hope you feel better

Re:Cognitive deficits in people who have recovered from Covi... by throwaway1092 on Wednesday October 21, 2020 @08:49AM (#24847284)
Thanks - already had/have a CPAP machine, so unfortunately that's not it.
Re:Cognitive deficits in people who have recovered from Covi... by jquery on Wednesday October 21, 2020 @10:40AM (#24848317)
> staunch believer in post-viral syndrome

+1

The last time I had a serious viral infection, I began having panic attacks and severe anxiety with mental fog, which didn’t go away when all the other symptoms did. My wife said I had “changed”.

When I tell doctors, they just kind of shrug. It sucks that it’s not taken seriously. I hope COVID-19 leads to more awareness of post-viral syndrome. Before Covid-19, we were all too cavalier about getting sick or getting other people sick.

Re:Cognitive deficits in people who have recovered from Covi... by vekker on Wednesday October 21, 2020 @08:07AM (#24846964)
This might seem a bit out there / like woo woo to some, but have you tried "breathing exercises" (intermittent hypoxia) and cold exposure to counter those effects you are talking about? Particularly, the Wim Hof Method?

I know it helps for people with autoimmune diseases anecdotally, but there's also some good scientific evidence for it.

Re:Cognitive deficits in people who have recovered from Covi... by sokoloff on Wednesday October 21, 2020 @08:23AM (#24847056)
I regularly monitor my O2 saturation (via an OTC pulse-ox) when flying unpressurized airplanes.

It’s extremely easy to raise my O2 sats at altitude by conscious deep-breathing, but IME, it’s incredibly difficult to lower them near sea-level by any amount of conscious breathing changes. I’m curious to try the Wim-Hof methods on my pulse ox and I’ll do that, but I fully expect to see consistent 98-99% O2 sats here at 10 meters above sea level with anything other than changing the air composition to reduce partial pressure of O2.

Re:Cognitive deficits in people who have recovered from Covi... by labseven on Wednesday October 21, 2020 @09:41AM (#24847772)
From my understanding, the deep breathing doesn't particularly raise O2 (which is already 97-99%) but purges CO2, which then lets you hold your breath (empty lungs) for 2-3 minutes. In this period, my O2 (on my finger) drops to 85% before I feel a need to breathe in. It is important to 'replenish' the CO2 between deep breathing, otherwise I get very loopy.
Re:Cognitive deficits in people who have recovered from Covi... by neuronic on Thursday October 22, 2020 @05:53AM (#24856369)
Yep, and it certainly helps. Also Dr. Joe Dispenza's Mind Body Connection. I think a lot comes from stress, anxiety and dealing with your body with a wrong mindset.

But it doesn't explain all the issues away.

Re:Cognitive deficits in people who have recovered from Covi... by afiori on Wednesday October 21, 2020 @08:04AM (#24846947)
This has some parallels to what happened to me as a child, in that case it was clear that some kind of post-viral syndrome was in effect, but I never connected to the brain fog (I would describe my sensation as my brain turning into fog) I got some years later.
Re:Cognitive deficits in people who have recovered from Covi... by regularfry on Wednesday October 21, 2020 @07:27AM (#24846710)
The error bars overlap with the "hospitalised without ventilation" group. There's probably something else going on, and the authors do call out the known cognitive effects of hypoxia.
Re:Cognitive deficits in people who have recovered from Covi... by nradov on Wednesday October 21, 2020 @08:36AM (#24847153)
There is some evidence that anesthetics can cause cognitive impairment.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6443620/

Re:Cognitive deficits in people who have recovered from Covi... by kube-system on Wednesday October 21, 2020 @11:03AM (#24848531)
I was under the impression, at least as it pertained to the elderly, that GA is commonly known to be a significant risk.
Re:Cognitive deficits in people who have recovered from Covi... by nradov on Wednesday October 21, 2020 @05:48PM (#24852604)
Any type of long hospital stay frequently causes delirium among the elderly. GA makes it worse.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3065676/

Re:Cognitive deficits in people who have recovered from Covi... by xd on Wednesday October 21, 2020 @07:16AM (#24846648)
Also, I had a brief look over the paper but couldn't find anything to control for isolation since lockdown .. surely this would of had an effect on peoples cognition.

On a side note, maybe it's just me but I keep seeing comments that don't follow a "politically" accepted view point, being down vote like yours.

Re:Cognitive deficits in people who have recovered from Covi... by w_t_payne on Wednesday October 21, 2020 @07:19AM (#24846664)
Maybe it's because this whole situation has been ridiculously politicized, to the point where it's difficult to have a rational fact-based discussion.
Re:Cognitive deficits in people who have recovered from Covi... by hejja on Wednesday October 21, 2020 @07:25AM (#24846698)
...about anything. not just covid.
Re:Cognitive deficits in people who have recovered from Covi... by EForEndeavour on Wednesday October 21, 2020 @01:19PM (#24849956)
That's exactly what someone with your political beliefs would say!!
Re:Cognitive deficits in people who have recovered from Covi... by api on Wednesday October 21, 2020 @08:28AM (#24847099)
If isolation with a net connection for a few months dropped multiple IQ points, then all the shut-ins who do nothing but hang around on the Internet all day would be losing multiple tens of IQ points a year and would be functionally disabled by now.
Re:Cognitive deficits in people who have recovered from Covi... by webmaven on Thursday October 22, 2020 @01:17AM (#24855113)
> If isolation with a net connection for a few months dropped multiple IQ points, then all the shut-ins who do nothing but hang around on the Internet all day would be losing multiple tens of IQ points a year and would be functionally disabled by now.

You're assuming the effect is both permanent and cumulative.

An analogous effect: Clinical depression is also known to lower IQ in a subset of sufferers (for some oddballs, it's actually their main symptom). But the effect is neither permanent, nor cumulative. When the depression lifts, so does IQ (usually with a bit of delay).

So I would surmise that the same may be true of IQ deficits caused by prolonged isolation.

Re:Cognitive deficits in people who have recovered from Covi... by jmull on Wednesday October 21, 2020 @07:36AM (#24846767)
I don't know why people downvote things, but in this case I would hope it's because the previous comment was pretty superficial. Whether the covid causes cognitive decline through causing the use of a ventilator, sedatives, and immobilization or through some other mechanism still means it causes cognitive decline. So there's a basic logic flaw. Also, quite a large number of people have been put on ventilators due to covid-19, not "almost nobody". That's just an incorrect assertion. You'd like to attribute the downvoting to politics, but given the quality issues, I think that's a hard claim to support.
Re:Cognitive deficits in people who have recovered from Covi... by paradox242 on Wednesday October 21, 2020 @11:15AM (#24848623)
As other have already commented, they have already considered your theory in their analysis:

"Consequently, the observation of post-infection deficits in the subgroup who were put on a ventilator was not surprising. Conversely, the deficits in cases who were not put on a ventilator, particularly those who remained at home, was unexpected."

This effect on those hospitalized is not the primary thrust of their paper. Instead it was the observed effects on those who were not hospitalized or had mild to no respiratory symptoms. They raise many possibilities about why this may be the case and only assert that this effect at least proceeds into the recovery phase. I did not read any claims about this being permanent, broadly speaking.

Re:Cognitive deficits in people who have recovered from Covi... by simonh on Wednesday October 21, 2020 @09:52AM (#24847874)
Most of the impact seems to occur even without serious symptoms:

>bio-positive cases who reported being ill with no breathing difficulties showed a 0.32SD magnitude cognitive deficit.

My wife's hospital was full to the corridors with 'almost nobody's.

Re:Cognitive deficits in people who have recovered from Covi... by biolurker1 on Wednesday October 21, 2020 @03:53PM (#24851380)
As many previous comments said, the article includes mild disease